Field of the Invention
The present invention relates generally to medical devices and, more particularly, to specialized patient supports interrelated with medical data acquisition devices for optimally monitoring, processing, storing, displaying and utilizing patient data.
Background of the Invention
Patient data is often life-critical, especially in trauma and intensive care settings. It provides caregivers with objective information about the patient""s condition. By comparing simultaneous data relating to a variety of strategic physiological parameters, caregivers can not only monitor and diagnose the patient""s condition, but they can also evaluate the efficacy (and hence, value) of the patient""s treatment.
With more technologies being utilized, the critical care room can easily become crowded, complicated and confusing. Each patient will typically have a vital signs monitor, a ventilator, multiple intravenous pumps, and half a dozen or so other ancillary life-supporting and/or therapeutic devices. The number grows as our understanding of medicine increases and more technologies become available. As for monitors alone, it is not uncommon to have your basic vital signs monitor plus another three or four specialized monitors crowded into any given room, with each unique monitor being mounted on a separate wheeled cart, often recording and displaying only a single vital sign. Patient temperature, blood pressure, EKG, heart rate, and SaO2 (i.e., blood oxygen levels) are routinely monitored, as well as any number of additional vital signs or conditions that may be of particular interest with a given patient. A modern critical care room may also utilize a bedside computer terminal for patient charting. The caregiver brings up the patient""s chart electronically to determine what procedures have been prescribed and updates it as appropriate. The overall result is a complex network of wires, transducers, displays, bulky cabinets, and device carts surrounding the critical care patient.
Use of patient-rotating beds and the like, such as those described in U.S. Pat. Nos. 5,142,719 and 4,763,463, presents particular difficulties in dealing with the complexity of critical care monitoring systems. Such beds inherently move a patient""s body, typically rotating the body at least 90xc2x0 from side to side. Since the patient""s position is constantly moving relative to his monitors, the transducers and their cables must accommodate such movement. If a transducer is connected to a patient when the patient is rotated right, the transducer lead might be drawn taught as the patient is rotated to the left if the caregiver has not provided adequate slack in the line. The potential consequences are obviousxe2x80x94not only can transducers become dislodged or disconnected, but the wires can interfere with both equipment and caregivers.
Assuming all the leads remain properly connected, a caregiver then has the task of watching and mentally correlating each of the various displays with the patient to make decisions as to patient treatment. For instance, if a patient""s blood pressure is down, the patient may need to be positioned in the Trendelenburg position, or if SaO2 levels are low, automatic ventilation or kinetic therapy may be prescribed. The long-recognized need in the critical care setting is to simultaneously correlate as much patient data with as many effective therapies as may be necessary to maintain and/or improve the patient""s condition.
The need to occasionally transport a patient from one room to another further complicates matters. When transporting, each of the numerous pieces of wheeled equipment must simultaneously be rolled to the new location. Moreover, since virtually all the various technologies must first be disconnected from their wall power for transport, they must each have stand-by-power for transport, or be manually operated if possible. Many such stand-by schemes inherently risk loss of stored data in-transit. The result, too often, is to simplify matters by completely disconnecting the equipment during transport, when patient data is equally if not more important.
While others have long recognized the need to consolidate and simplify patient monitoring systems, competition amongst manufacturers tends to work against integration. Many manufacturers would rather set the standards for equipment interface, positioning themselves as the leader and forcing others to follow. They do not want other devices to utilize their information but would rather have customers be tied to them. They want customers to buy not only their transducers, but also their profit-laden monitors. Although some companies have established products which incorporate various devices in a transportable unit, the result too often is a seemingly insurmountable lack of communication between medical device transducers and monitors made by different competitors.
It is the overriding object of the present invention to address the problems and encumbrances of the prior art, providing a simpler, more convenient and efficient interface for medical data acquisition. This will enable caregivers to more efficiently monitor data, evaluate patient status, and adapt patient therapy, in virtually all circumstances. The particular applications range from basic lead connections, to pressure relieving mattresses, to lateral rotation beds.
Simplifying particular aspects of the invention, it basically comprises a critical care bed for supporting a patient wherein the bed serves as the information conduit between one or more transducers and their respective monitors and or other data recording devices. The bed itself also includes a processor for processing signals from the transducers. The transducers function conventionally, providing analog signals corresponding to sensed physiological characteristics of the patient. Conventional transducer leads and lead connectors are virtually inherent. The processor may also be conventional, although it is adapted for simplifying signal analysis and monitor recognition.
In one aspect of the present invention, the bed is provided with a universal port for receiving any one of a number of conventional lead connectors and linking the same to the processor. A plurality of linked alternative ports could be structured as another alternative. In such configurations, the processor is adapted to sense the signals received at the universal port (or from any one of the series of ports) and to xe2x80x9crecognizexe2x80x9d the source of such signals. With most digital signals, the data stream can be matched to the corresponding medical device. Source recognition for all analog signals and certain digital signals, on the other hand, will typically involve signal analysis of the signal on each pin of a transducer and then pin-mapping all the signals together. The signal analysis identifies the type of signal being coveyed on a particular pinxe2x80x94i.e., whether the signal is a steady, reference voltage or a fluctuating one sand, if fluctuating, whether it is fluctuating in a manner characteristic of any particular type of physiologic or environmental signal. Pin-mapping then correlates the signals of the various pins of a multi-pin transducer lead to distinguish an identifying profile and identify the corresponding signal source from the known bank of possibilities. With such a configuration, the system as a whole can then identify the make of multi-pin transducer signals and process the signals based on pre-defined data related to the particular signal source (i.e., the particular type and/or make of patient transducer).
For optimal convenience and minimal interference, a plurality of such universal ports may be positioned along opposite sides and/or at opposite ends of the patient support surface. Another aspect of the invention relates to a display system for displaying usable representations of received signals. Preferably, each signal is processed and then displayed in a graphic format relative to time, or a caregiver can selectively switch the display to digital display of current or time-averaged levels. The display is naturally linked with the processor, which in turn is adapted for interpreting and displaying data utilizing the display system. Uniquely, the display system itself is detachably mounted to the bed so that it can be detached in certain placements or at certain times. Preferably, such a detachable display is formed as a cartridge which includes not only the display but also the processor. Hence, whenever a patient, caregiver or facility desires to implement the features provided by the present invention, such a cartridge can be readily mounted and implemented on short notice without unnecessary replacement of the entire critical care bed. Such a display cartridge includes not only a slim-line processor but also a flat display screen to minimize bulk and to ease implementation. The cartridge is also adapted to allow the display screen to pivot relative to the bed for enabling convenient line-of-sight viewing by a caregiver at any location.
Another aspect of the present invention provides for integrating an SaO2 monitoring system with a display system that enables a caregiver to correlate SaO2 monitoring system with a display system that enables caregiver to correlate SaO2 with lateral rotation data. The result allows correlation between blood-oxygen levels and the therapeutic turning effect of the rotation. Such a system may also utilize a universal port as referenced previously, and may be logistically linked with the critical care bed controls to modify the therapy protocol in response to the current and or historical SaO2 levels. Eventual concepts of incorporating self regulating systems of patient care or physician approved suggestions of a smart system could be included. Axial routing of data lines from the transducers to the detachable processor and thence to the respective external monitors not only renders a convenient data conduit, but also helps eliminate potential for taught-line problems.
Many other objects, features and advantages of the present invention will be evident to those of ordinary skill in the art from the following more detailed description of presently preferred embodiment, particularly when considered in light of the accompanying drawings and the appended claims.